o 
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GIFT 

OF 

UNITED  STATES  NAVAL  MEDICAL  SCHOOL 

WASHINGTON,  D.  C 


Addresses  Delivered  at  the 
Closing  Exercises 

(FOURTEENTH  SESSION:  APRIL  12,  1916) 


BY 


MEDICAL  DIRECTOR  JAMES  D.  GATEWOOD,  U.  S.  N. 

PRESIDENT  OF  THE  SCHOOL 

THE  HONORABLE  JOSEPHUS  DANIELS 

SECRETARY   OF  THE   NAVY 

SURGEON  GENERAL  WILLIAM  C.  BRAISTED 

UNITED  STATES   NAVY 
AND 

HUBERT  A.  ROYSTER,  M.  D. 

RALEIGH,  N.  C. 


COMMENCEMENT  ADDRESS: 


The  Humanity  of  Surgery 


ff  OF  THE 

;     U  N  1  V  E  K  3  I  T  Y 

WASHINGTON  ^r- 

GOVERNMENT  PRINTING  OFFICE  ^SstZ-  I  F  ' ">  R 
1916 


UNITED  STATES  NAVAL  MEDICAL  SCHOOL 
WASHINGTON,  D.  C. 


Addresses  Delivered  at  the 
Closing  Exercises 

(FOURTEENTH  SESSION:  APRIL  12,  1916  ) 


BY 

MEDICAL  DIRECTOR  JAMES  D.  GATEWOOD,  U.  S.  N. 
[PRESIDENT  OF  THE  SCHOOL 

THE  HONORABLE  JOSEPHUS  DANIELS 

SECRETARY  OF  THE  NAVY 

SURGEON  GENERAL  WILLIAM  C.  BRAISTED 

UNITED  STATES  NAVY 
AND 

HUBERT  A.  ROYSTER,  M.  D. 

RALEIGH,  N.  C. 


COMMENCEMENT  ADDRESS: 

The  Humanity  of  Surgery 


WASHINGTON 

GOVERNMENT  PRINTING  OFFICE 
1916 


366836 


PROGRAM. 


Invocation,  by  Chaplain  G.  L.  Bayard,  United  States  Navy. 

Address  of  welcome,  by  Medical  Director  J.  D.  Gatewood,  United'States  Navy. 

Presentation  of  diplomas,  by  the  Secretary  of  the  Navy. 

Address,  by  the  Secretary  of  the  Navy. 

Address,  by  Surg.  Gen.  W.  C.  Braisted,  United  States  Navy. 

Commencement  address,  "The  Humanity  of  Surgery,"  by  Hubert  A.  Royster,  M.  D. 

Benediction,  by  Chaplain  G.  L.  Bayard,  United  States  Navy. 

(3) 


GRADUATING  CLASS. 


Asst.  Surg.  John  Harper,  Medical  Keserve  Corps,  United  States  Navy. 
Asst.  Surg.  Richard  H.  Miller,  Medical  Reserve  Corps,  United  States 

Navy. 
Asst.  Surg.  Paul  Richmond,  Jr.,  Medical  Reserve  Corps,  United  States 

Navy. 
Asst.   Surg.   Forrest  M.   Harrison,  Medical  Reserve  Corps,   United 

States  Navy. 
Asst.  Surg.  Lawrence  F.  Drumm,  Medical  Reserve  Corps,  United 

States  Navy.     • 
Asst.  Surg.  George  W.  Taylor,  Medical  Reserve  Corps,  United  States 

Navy. 
Asst.  Surg.  Walter  A.  Vogelsang,  Medical  Reserve  Corps,  United 

States  Navy. 
Asst.  Surg.  Elphege  A.  M.  Gendreau,  Medical  Reserve  Corps,  United 

States  Navy. 
Asst.  Surg.  Grover  C.  Wilson,  Medical  Reserve  Corps,  United  States 

Navy. 
Asst.  Surg.  Russell  J.  Trout,  Medical  Reserve  Corps,  United  States 

Navy. 
Asst.  Surg.  Virgil  H.  Carson,  Medical  Reserve  Corps,  United  States 

Navy. 

(4) 


CLOSING  EXERCISES. 


ADDRESS    OF    MEDICAL   DIRECTOR   JAMES  D.  GATEWOOD,  UNITED 

STATES  NAVY, 

President  of  the  School. 

LADIES  AND  GENTLEMEN  :  It  happens  to  be  my  privilege,  as  well  as 
duty,  to  say  a  few  words  here. 

You  know  this  is  a  situation  that  recurs.  Each  year  there  is  an 
audience  composed  of  interested,  heartening,  and  welcome  witnesses ; 
there  is  a  class  made  up  of  those  who  have  met  the  school  require- 
ments; and  there  are  certain  exercises  that  include  the  bestowing 
upon  each  class  member  of  a  certificate  showing  his  successful  work. 

But  this  situation  dissolves.  It  is  preliminary  to  the  departure 
of  each  of  the  central  figures,  of  each  member  of  the  class.  They  all 
go  out  to  sea,  starting  voyages  of  great  length  and  in  many  directions. 

Now  this  reminds  one,  as  a  mere  simile,  of  a  number  of  vessels 
dropping  downstream  at  the  same  time  and  going  out  to  sea.  You 
have  stood  on  the  sands  and  watched  them  and  you  have  noted  that 
as  each  gets  into  deep  water  it  proceeds  on  its  own  predetermined 
course,  but  that,  whatever  the  course,  it  is  always  toward  the  horizon. 

To  you,  standing  on  the  sands,  each  vessel  attains  the  horizon  and 
disappears  in  its  mists.  But  from  the  point  of  view  of  those  on  the 
vessel  the  horizon  is  never  reached,  the  great  inverted  bowl  of  the 
sky  ever  hanging  directly  overhead,  with  rim  touching  the  sea  just  so 
many  miles  away. 

Perhaps  in  this  can  be  found  some  reminder  of  different  types  of 
men — of  men  varying  in  their  attitudes  toward  life.  We  live  by  our 
visions,  and  the  ambitious,  venturesome,  or  progressive,  using  the 
light  of  imagination  or  guided  by  reason  and  judgment,  discern  dim 
objects  on  the  horizon  of  the  sea  of  life  toward  which  they  feel 
impelled  to  move.  But  lo!  when  they  satisfy  those  desires,  when 
they  find  something  greatly  coveted,  the  horizon  is  still  as  far  away 
as  ever,  and  other  shapes  are  looming  there  calling  to  restless  minds. 

But  the  onlooker,  the  man  of  routine,  does  not  seem  to  struggle, 
does  not  seem  to  travel,  as  his  horizon  is  ever  the  same.  His  general 
view  of  life  does  not  vary.  He  sees  many  pass  by,  and  he  also  notes 
many  wrecks  in  his  time.  He  studies  his  vicinity,  he  goes  over  and 

(5) 


over  the  same  course  day  after  day.  He  does  things  in  the  same  way, 
and  numerous  harbors  of  refuge  are  always  near  at  hand.  Each 
situation  has  a  precedent,  and  he  steers  by  it.  He  does  not  own  the 
routine;  the  routine  owns  him.  And  he  is  apt  to  have  a  kind  of 
blindness,  a  limitation  of  the  field  of  vision. 

Yet  I  do  not  wish  to  be  understood  as  talking  against  routine  and 
against  system.  Each  life  becomes  quite  valueless  without  them. 
But  they  ought  to  be  owned,  they  ought  to  be  appropriated  as  a 
means.  They  cause  too  great  limitations,  they  stifle  the  imagination, 
and  they  kill  originality  of  thought  when  they  are  the  owners  and  not 
the  slaves  of  men. 

Now,  the  central  idea  of  all  this  is  travel.  We  speak  of  life's  voyage, 
of  the  sea  of  life,  of  man's  walk  in  life,  and  of  the  race  of  life  in  which 
one  man  passes  another.  We  think  of  the  faces  of  those  whom  we 
have  loved,  admired,  and  respected  but  who  are  no  longer  with  us; 
and  we  feel  that  they  have  gone  on  before.  We  thus  unconsciously 
recognize  that  we  are  all  travelers,  all  moving  toward  the  bourne 
from  which  no  traveler  returns. 

Thus  the  question  arises  as  to  what  traveling  is.  Certainly  it  is 
not  a  mere  matter  of  transportation.  Under  that  idea  a  trunk  could 
be  made  to  travel  with  the  assistance  of  a  baggage  check. 

In  fact,  man  travels  by  his  mind.  The  shoemaker,  as  he  passes 
the  thread  or  hammers  in  the  peg,  revisits  his  home  in  southern  Italy. 
The  writer  or  student  of  history  sees  the  temples  of  Egypt  or  walks 
the  streets  of  ancient  Greece,  or,  sitting  in  the  Colosseum,  hears  the 
Jidbct  of  the  Roman  populace  in  the  days  of  the  Caesars.  The  poet 
wanders  through  the  hearts  of  men  and  lifts  their  faces  to  the  stars. 
And  the  writer  of  romance  accompanies  you  through  the  intricacies 
of  plot,  carries  you  into  his  world,  and  introduces  you  to  his  people. 
A  man  travels  by  his  mind. 

Futhermore,  the  member  of  the  human  race  who  puts  forward 
something  of  continuing  importance  to  mankind  lives  and  travels 
forever  with  those  he  has  benefited.  The  cablegram  you  receive 
has  traveled  thousands  of  miles  along  the  ocean  bed  and  carried  to 
you  something  of  the  mind  of  Morse.  The  wireless  sending  its  im- 
pulses through  the  ether  also  sends  through  space  something  of  the 
mind  of  Marconi.  Each  day  thousands  of  miles  of  telephone  wire 
carry  countless  messages  that  depend  for  transportation  upon  some- 
thing that  has  come  to  us  through  the  mind  of  Bell  and  others.  And 
each  night  as  the  great  ship  pushes  its  way  through  the  waters 
there  is  something  there  of  the  mind  of  Fulton  and  a  host  of  others — 
strangers  to  us,  many  of  them,  but  travelers  are  often  strangers  in 
strange  surroundings. 

And  there  is  a  science  and  art  of  traveling  as  truly  worth  culti- 
vating as  the  science  and  art  of  medicine  or  the  science  and  art  of 


surgery.  There  is  a  spirit  of  patient  observation  to  be  cultivated, 
an  understanding  of  the  feelings  of  others  through  which  one's  own 
selfishness  lessens.  Even  hi  our  own  homes  we  are  all  travelers — 
the  place  where  it  too  often  happens  that  we  know  one  another  so 
well  that  we  do  not  know  one  another  at  all. 

And  now  you,  members  of  this  class,  central  figures  on  this  occa- 
sion, are  about  to  begin  your  travels  in  the  Navy.  Are  you  thinking 
of  a  ship  merely  as  a  means  of  transportation  from  one  port  to 
another,  from  one  seacoast  city  to  another  ?  I  tell  you  that  a  man 
travels  by  his  mind  and  that  it  is  about  the  ship  you  must  travel. 
Your  travel  on  the  ship  is  merely  incidental.  You  must  study 
your  ship  from  bow  to  stern,  from  upper  deck  to  keel.  You  must 
know  bilges,  holds,  and  storerooms.  And  you  must  consider  long 
and  carefully  'the  living  quarters.  Are  they  well  ventilated  under 
all  conditions,  are  they  clean,  are  they  well  lighted,  are  they  suitable 
habitations  for  men?  Is  anything  wrong,  and,  if  so,  what  can  be 
done?  You  must  know  the  water  supply,  literally  know  it  all  the 
time.  You  must  even  know  the  character  of  paint  in  composition 
and  color  employed  within  the  ship,  for  there  are  relations  to  the 
health  of  crews.  There  are  innumerable  things,  here,  there,  and 
everywhere  within  the  ship  that  should  make  constant  appeal  to 
the  trained  mind.  You  must  know  everything  a  good  traveler 
should  know,  and  this  includes,  in  your  case,  not  only  the  care  of 
sick  and  injured,  and  preparation  for  battle,  but  also,  and  primarily, 
the  prevention  of  sickness,  the  preservation  of  the  health  of  men. 

And  shall  you  not  all  be  travelers  together?  In  the  wardroom 
you  will  rub  elbows  with  a  number.  Will  you  really  know  them? 
Will  you  see  the  strength  as  well  as  the  weakness  ?  Will  you  know 
that  men  can  not  be  judged  by  their  weakesses  but  rather  by  their 
power  to  lift  their  heads  above  others  in  time  of  stress  and  peril? 
I  warn  you  to  be  good  travelers,  to  study  the  personnel,  to  cultivate 
the  spirit  of  the  Navy,  the  love  of  duty  that  is  stronger  than  the 
love  of  life. 

Will  you  play  the  game  earnestly  and  as  a  very  part  of  it  ?  Will 
you  cultivate,  truly  cultivate,  the  art  of  traveling — the  spirit  of 
patient  and  unselfish  observation  ?  I  ask  you  because  your  careers 
will  be  watched  with  great  interest.  Word  will  come  back  here 
where  you  start.  Will  it  be  a  good  voyage  you  are  about  to  make  ? 
A  man  travels  by  his  mind. 

41429—16 2 


ADDEESS    OF   THE   HONORABLE  JOSEPHTTS   DANIELS, 
Secretary  of  the  Navy. 

It  gives  me  great  pleasure  to  welcome  you  into  the  Navy.  Two 
years  ago,  when  I  had  the  privilege  of  welcoming  the  graduating  class, 
I  undertook  in  a  brief  address  to  invite  the  attention  of  the  young 
surgeons  coming  into  this  high  profession  to  the  career  of  that  gre;it 
Scotch  doctor,  William  MacLure,  and  I  should  be  glad  if  all  you 
young  men  would  make  the  spirit  of  Ian  MacLaren's  hero  your 
emulation.  Last  year  I  invited  your  attention  to  the  life  story  of 
Dr.  Amboyne,  the  hero  of  an  older  but  equally  great  novel,  Charles 
Reade's  "Put  Yourself  in  His  Place,"  of  whom  his  patients  said: 
"Talking  with  you,  doctor,  is  like  drinking  sunshine."  I  would  like 
to-day  to  call  your  attention  to  a  distinguished  physician,  a  literary 
master,  not  the  product  of  the  brain  of  a  great  novelist,  but  a  man 
of  flesh  and  blood,  who,  beginning  his  profession  in  London,  arose 
to  the  highest  eminence  and  did  what  so  few  doctors  have  done — 
left  behind  him  a  memorial  of  his  life  work,  "The  Diary  of  a  Late 
Physician."  This  great  man  went  to  London  and  for  years  fought 
his  way  to  practice,  and  after  he  had  been  in  the  profession  for  years 
had  the  honor  of  making  $200  a  year  and  a  small  additional  amount 
by  writing.  And  yet  in  his  philosophy  and  in  his  life  he  held  up  a 
very  high  ideal  before  your  profession.  While  his  Diary  must  have 
been  suggestive  and  inspirational  to  the  professional  men  of  his  day, 
its  chief  value  lies  in  the  spirit  of  sympathy  which  pervades  the 
recital  of  each  case  described.  The  introduction  contains  these  words : 

The  bar,  the  church,  the  Army,  the  Navy,  and  the  stage  have  all  of  them  spread 
the  volumes  of  their  secret  history  before  the  prying  gaze  of  the  public,  while  that 
of  the  medical  profession  has  remained  hitherto,  with  scarcely  an  exception,  a  sealed 
book.  And  yet  there  are  no  members  of  society  whose  pursuits  lead  them  to  listen 
more  frequently  to  what  has  been  exquisitely  termed,  "The  still,  sad  music  of 
humanity." 

No  doubt  it  was  the  bitterness  and  hardship  of  the  early  struggle 
for  success  which  helped  to  beget  in  the  heart  of  this  physician  the 
tenderness  and  kindliness  which  characterized  the  practice  of  his 
profession  throughout  his  long  and  useful  life. 

In  his  paper  entitled  "Cancer,"  Dr.  Warren  draws  a  fine  picture 
of  the  strength  of  weakness  as  exemplified  hi  the  endurance  of  a 
young  mother  of  about  27  years  of  age  whose  husband,  a  captain 
in  the  incomparable  navy  of  Great  Britain,  was  far  away  engaged 
in  his  country's  service.  The  description  of  the  operation  for  cancer, 

(8) 


located  on  the  face  and  from  which  the  vi6tim  suffered  great  pain, 
is  interesting  in  the  light  of  present-day  appliances  and  efficiency. 
As  this  beautiful  woman  came  into  the  room  in  her  residence  where 
the  operation  was  to  be  performed,  this  sympathetic  doctor  de- 
clares that  his  heart  ached,  and  goes  on  to  say:  "A  decanter  of  port 
wine  and  some  glasses  were  placed  on  a  small  table  near  the  win- 
dow." This  was  the  anesthetic.  The  number  of  glasses  indicated 
that  the  wine  was  to  do  double  duty — to  strengthen  the  patient  for 
the  operation  and  to  nerve  the  distinguished  surgeon,  whom  Dr. 
Warren  had  called  in  to  use  the  knife,  for  his  difficult  task.  The 
subject  of  the  operation  barely  touched  the  glass  with  her  lips,  and 
then  implored  the  physician  to  hold  before  her  eyes  the  envelope 
of  a  letter  which  she  had  just  received  from  her  absent  husband 
and  which  she  declared  was  all  that  would  be  necessary  to  nerve 
her  for  the  ordeal,  and  this  Dr.  Warren  did  while  the  surgeon  used 
the  knife.  Then  the  Diary  continues: 

"'I  am  prepared/  said  she,  and  sat  down  in  the  chair  that  was 
placed  for  her.  One  of  the  attendants  removed  the  shawl  from  her 

shoulders  *  *  *.  She  then  suffered  Sir to  place  her  on 

the  corner  side  of  the  chair,  with  her  left  arm  thrown  over  the  back 
of  it,  and  her  face  looking  over  her  left  shoulder.  She  gave  me  her 
right  hand ;  and,  with  my  left,  I  endeavored  to  hold  Capt.  S —  — 's 
letter,  as  she  had  desired.  She  smiled  sweetly,  as  if  to  assure  me 
of  her  fortitude;  and  there  was  something  so  indescribably  affecting 
in  the  expression  of  her  full  blue  eyes,  that  it  almost  broke  my 
heart  *  *  *.  Sir  -  — ,  now,  with  a  calm  eye  and  a  steady 
hand,  commenced  the  operation.  At  the  instant  of  the  first  incision, 
her  whole  frame  quivered  with  a  convulsive  shudder,  and  her  cheeks 
became  ashy  pale.  I  prayed  inwardly  that  she  might  faint,  so  that 
the  earlier  stage  of  the  operation  might  be  got  over  while  she  was 
in  a  state  of  insensibiliy.  It  was  not  the  case,  however — her  eyes 
continued  riveted  on  the  beloved  handwriting  of  her  husband; 
and  she  moved  not  a  limb,  nor  uttered  more  than  an  occasional 
sigh,  during  the  whole  of  the  protracted  and  painful  operation. 
When  the  last  bandage  had  been  applied,  she  whispered  almost 
inarticulately,  'Is  it  all  over,  doctor  ? '  ' 

The  patient  was  then  lifted  by  the  physician  and  the  surgeon,  and 
carried,  sitting  in  the  chair,  up  to  her  bed,  whereupon  she  instantly 
swooned,  "and  continued  so  long  insensible  that  Sir  -  —  held 
a  looking  glass  over  her  mouth  and  nostrils,  apprehensive  that  the 
vital  energies  had  at  last  sunk  under  the  terrible  struggle.  She 
recovered,  however,  and  under  the  influence  of  an  opiate  draught, 
slept  for  several  hours.  The  operation  resulted  in  permanent  cure 
and  the  account  of  this  operation,  of  about  just  100  years  ago,  and 
which,  by  way  of  contrast  with  what  you  young  gentlemen  are 


10 

accustomed  to  in  the  way  of  surgical  facilities,  must  be  interesting 
to  you,  ends  with  a  statement  which  the  patient  made  to  Dr.  Warren 
just  before  he  discharged  her  from  his  care.  As  a  faint  crimson 
mantled  her  cheek,  she  expressed  regret  over  the  personal  disfigure- 
ment she  had  suffered,  but  added  falteringly  after  a  pause,  "I  think 
Capt.  S -  (meaning  her  husband)  will  love  me  yet." 

This  single  illustration  from  the  diary  serves  to  show  that  there 
was  carried  about  by  this  man  something  of  light  and  cheer  and  help, 
because  he  recognized  what  the  world  needed  more  than  anything 
else  was  human  sympathy.  Sympathy  is  needed  on  shipboard,  where 
men  are  away  from  the  restraints  of  home  influence.  You  come  into 
a  profession  of  noble  traditions.  You  come  into  a  service  where  you 
are  not  compelled  to  wait  for  patients.  Samuel  Warren  waited  a 
fourth  of  his  life  for  an  opportunity  to  secure  them.  This  month 
there  will  graduate  in  America  hundreds  of  young  men  who  will  go 
into  the  practice  of  medicine,  and  the  first  thing  they  will  ask  them- 
selves when  they  get  their  diplomas  is,  "  Where  will  I  practice  and 
where  will  I  find  patients?"  and  many  of  them, skilled  and  learned  as 
they  are,  must  perforce  undergo  a  long  waiting  period  before  the 
opportunity  to  distinguish  themselves  will  come.  You  are  entering 
a  department  of  service  where  there  is  no  waiting  period.  Your 
diploma  to-day  gives  you  a  title,  an  office,  a  clientele,  patients 
selected  out  of  the  best  in  all  America,  for  the  Navy  is  the  process  of 
elimination  as  in  no  other  service  in  the  world.  It  is  a  selected  serv- 
ice. Among  every  six  men  who  apply  to  come  into  the  enlisted 
ranks  we  accepted  only  one,  the  other  five  having  failed.  The  Naval 
Academy  would  be  fortunate  if  70  per  cent  of  the  young  men  who  got 
appointments  were  able  to  enter,  and  the  process  goes  on  year  by 
year  throughout  the  whole  life  of  the  men  in  the  Navy.  I  heard  a 
captain  say  not  long  ago  that  he  was  being  "pawed  over  all  his  life, 
examined,  tested,  and  thumped,  to  find  out  whether  he  was  mentally, 
morally,  and  physically  fit."  It  is  for  you  to  say,  therefore,  whether 
the  Navy  shall  be  fit  and  strong,  because  no  man  can  enter  unless  you 
pronounce  him  qualified.  It  is  your  duty  to  stand  at  the  door  of  the 
Navy  and  say  only  the  fittest  survive,  and  bring  into  the  service 
young  men  of  character  and  physical  excellence,  and  when  they  come 
in  it  is  your  business  to  keep  them  well  and  strong.  In  the  olden 
days  of  the  practice  of  medicine,  we  employed  a  physician  if  we  were 
sick  to  make  us  well;  that  was  an  ancient  theory.  In  the  Navy  now 
we  employ  physicians  to  keep  the  Navy  well.  We  are  learning  the 
importance  and  power  of  prevention. 

When  you  go  on  the  ship,  you  will  be  the  physician,  the  friend,  the 
associate,  of  these  selected  men,  and  while  the  captain  of  that  ship 
will  say  the  last  word,  you  will  have  the  supreme  influence  in  the 


11 

lives  of  the  young  men  if,  along  with  your  skill,  you  have  human 
sympathy  and  the  touch  of  kindness  for  the  homesick  lad. 

You  are  coming  into  the  Navy  at  the  tune  of  its  greatest  expansion 
and  on  the  threshold  of  an  efficiency  never  before  known.  Sixty 
thousand  men  look  to  you  to  keep  them  ready,  and  you  have  learned 
enough  to  know  that  men  can  not  be  made  ready  instantly.  Michael 
Dorizas,  the  Greek  athlete  and  undefeated  wrestler  of  the  University 
of  Pennsylvania,  asked  when  he  made  his  special  preparation  for  his 
bouts,  replied :  "  I  never  prepare ;  I  am  always  ready. "  The  man  who 
has  to  get  ready  is  the  man  who  is  never  ready.  Those  were  inspiring 
words  of  Admiral  Badger  when  the  Navy  was  ordered  to  Vera  Cruz. 
Within  48  hours  that  majestic  fleet,  fully  equipped,  was  on  its  way, 
with  our  present  Surgeon  General  as  fleet  surgeon.  He  had  no  orders 
except  to  go  to  Vera  Cruz.  When  asked  what  he  was  going  to  do,  he 
said:  "I  do  not  know  what  we  may  be  called  upon  to  do,  but  we  are 
ready." 

In  most  professions  there  is  a  glamor  and  a  glory  to  men  who  win 
its  highest  rewards.  You  are  coming  into  a  profession  in  which  you 
will  not  stand  in  the  forum  when  you  fight  your  great  battles.  Sen- 
ators and  advocates  and  admirals  and  generals  have  an  inspiration 
from  the  applause  of  the  men  about  them.  You  will  win  your  con- 
flicts in  the  still  watches  of  the  night,  ministering  to  the  humble 
sailor,  whose  mother,  far  off,  loves  him  as  your  mother  loves  you; 
and  you  will  come  through  conflicts  and  victories  that  will  give  you 
a  sweetness  and  a  strength  that  never  came  to  those  who  had  the  ear 
of  listening  senates.  I  was  glad  to  read  some  tune  ago  that  the  State 
of  Georgia  had  determined  to  put  in  Statuary  Hall,  in  the  Nation's 
Capitol,  where  every  State  may  place  the  figure  of  two  of  its  greatest 
men,  the  statue  of  Dr.  Long,  the  first  surgeon  to  use  an  anesthetic. 
I  hope  we  will  see  the  day  when  other  States  will  recognize  that  it  is 
the  physician  as  well  as  the  general,  that  it  is  the  surgeon  in  the  sick 
bay  as  well  as  the  admiral  on  the  bridge,  who  deserves  the  highest 
recognition  and  rewards  from  a  grateful  Republic.  But  you  will  get 
these  rewards  only  if  you  touch  the  hearts  of  your  fellows. 

I  am  not  going  to  speak  to  you  about  progress  in  your  profession. 
Dr.  Gatewood,  who  is  the  head  of  this  institution,  who  inspired  you 
in  the  days  of  your  preparation  here  and  whose  ideals  are  that  we 
shall  take  into  the  Navy  no  man  who  has  not  shown  himself  qualified 
in  character  and  capacity,  has  done  this.  The  average  layman  thinks 
medicine  is  a  dry  subject.  President  Wilson  once  told  a  doubting 
pupil  at  Princeton  that  there  was  no  such  thing  as  a  dry  subject; 
that  the  only  thing  that  was  dry  was  the  mind  it  came  in  contact 
with,  and  if  that  mind  perceived  the  significance  of  the  subject,  it 
yielded  all  the  sap  that  was  necessary  for  the  most  intense  interest. 
You  must  bring  that  enthusiasm  aboard  ship.  The  chaplain  here 


12 

and  men  of  his  calling  who  are  devoting  their  lives  to  preaching  the 
gospel  can  not  do  all  that  you  can  do  because  there  is  something 
about  young  men  which  yields  to  the  advice  of  a  physician  when 
they  close  their  hearts  even  to  ministers.  It  is  because  they  recog- 
nize your  work  is  based  not  only  upon  spiritual  welfare  but  physical. 

Three  of  the  greatest  contributions  that  have  been  made  in  recent 
years  to  the  literature  of  your  profession  were  made  by  naval  officers. 
During  the  Russo-Japanese  War  your  distinguished  surgeon  general, 
Dr.  Braisted,  was  sent  to  study  conditions  in  the  Japanese  fleet  and 
Dr.  Spear  in  that  of  the  Russians.  They  wrote  reports  which  you 
should  read  and  which  have  helped  doctors  in  all  the  countries  en- 
gaged in  the  European  struggles,  and  only  this  year  Dr.  Fauntleroy 
made  a  study  of  conditions  in  Europe  that  is  illuminating  and 
invaluable. 

I  trust  that  as  you  enter  upon  your  careers  you  will  catch  the 
spirit  of  Samuel  Warren  who  wrote  about  his  profession  and  made 
the  world  see  its  nobility  and  that  you  will  write  like  Braisted,  Spear, 
and  Fauntleroy. 

I  am  glad  to  see  Dr.  Rixey  here,  under  whose  administration  the 
Medical  Corps  of  the  Navy  made  giant  strides. 

When  the  Saviour  was  upon  the  earth,  men  called  Him  by  many 
titles — King,  Master,  Teacher,  Lord,  and  Brother — but  we  love  best 
of  all  to  call  Him  the  Great  Physician;  and  I  think  it  is  His  highest 
title  and  that  which  brings  us  nearer  to  Him.  In  His  day  people 
were  healed  by  the  touch  of  His  hand  and  even  by  touching  the 
hem  of  His  garment.  He  has  gone  from  the  earth  and  we  do  not 
have  His  divine-human  touch  to-day,  but  there  is  something  akin 
to  it  in  the  love  of  fellow  man  which  you  will  exhibit  and  in  your 
helpfulness  of  men  to  clean  living  and  clean  thinking.  The  faith  they 
have  in  you  will  win  half  the  battle,  for  they  will  have  the  faith  that 
you  can  heal  them  by  even  the  touch  upon  the  friendly  hem  of  your 
skill  and  experience.  It  is  this  ideal  I  would  present  to  you  young 
gentlemen  who  have  come  into  this  profession,  and  if  you  will  live  up 
to  it,  as  I  am  sure  you  will,  and  follow  in  the  steps  of  other  strong 
men  of  the  Navy  who  give  their  lives  to  healing,  when  you  come  to 
the  time  of  retirement  you  may  look  bagk  on  your  lives  with  satis- 
faction, and  when  you  come  to  that  final  hour  may  say  truly,  as 
Jeanie  Deans  said:  "When  the  hour  of  death  comes,  that  comes  to 
hi^h  and  low,  then  it  isna  vrhat  we  hae  dune  for  oursells  but  what  we 

o  * 

hae  dune  for  ithers  that  we  think  on  maist  pleasantly." 


ADDRESS  OF  STTSG.  GEN.  W.  C.  BBAISTED,  UNITED  STATES  NAVY. 

Gentlemen,  it  is  always  with  a  feeling  of  the  deepest  obligation, 
and,  if  I  may  say  it  without  misinterpretation,  noblesse  oblige,  that 
I  have  risen  to  address  this  class  and  its  predecessors  on  the  occasion 
of  the  graduation  from  the  Naval  Medical  School.  I  have  been 
through  what  you  are  going  through,  I  have  trod  the  many  steps 
that  lie  ahead  of  you,  and  if  my  experience  in  the  service,  my  pleas- 
ures and  my  sorrows,  my  hopes  and  ambitions,  my  regrets  and  dis- 
appointments— if  these,  I  say,  can  in  any  way  be  offered  to  you  as 
a  guide  and  mentor  in  your  coming  life  work,  I  want  to  offer  them 
freely.  We  all  know  as  we  grow  older  that  youth  profits  but  little 
from  the  advice  of  age ;  it  is  a  sign  of  the  latter  when  the  realization 
is  borne  in  upon  us  that  millions  and  millions  have  passed  along  the 
same  road  over  which  we  have  been  deviously  toiling,  and  it  is  only 
given  to  the  young  to  idealize  the  future.  We  all  have  at  some  time 
sought  the  rainbow  and  the  pot  of  gold,  as  have  those  of  countless 
ages  before  us.  Despite  the  proverbial  impossibility,  let  us  hope 
that  many  have  reached  their  rainbow,  and  in  poverty  or  in  wealth, 
in  restless  energy  or  placid  seclusion,  attained  their  share  of  happi- 
ness and  contributed  their  mite  to  the  fund  of  human  good  and 
advancement. 

You  are  this  day,  gentlemen,  upon  the  threshold  of  a  career  in 
life.  Your  life  work  and  your  rewards  are  mapped  out  for  you  with 
a  degree  of  accuracy  and  certainty  that  is  generally  impossible  on 
graduation  from  the  usual  professional  course.  It  is  therefore  easier 
to  provide  helping  tenets  or  guide  posts  for  that  path  that  lies  before 
you. 

First  of  all,  I  regard  as  essential  your  own  appreciation  of  your 
future — its  permanency,  its  possibilities,  what  you  owe  to  it,  and 
what  opportunities  are  afforded  you  to  prove  your  right  to  exist 
therein  and  to  discharge  that  obligation  to  the  world  at  large  that 
is  the  duty  and  inheritance  of  every  living  being.  Crystallize  fixed 
ideas  of  ambition;  you  will  find  that  perseverance,  pertinacity,  appli- 
cation, pursuance  of  laudable  ideals,  will  attain  their  object  with  a 
facility  attributable  both  to  the  excellence  of  the  individual  and  the 
aid  afforded  by  conditions  where  all  are  more  or  less  working  for  a 
common  good. 

We  are  in  a  way  a  small  community  living  within  walled  bounda- 
ries, an  advanced  fortress  protecting  the  public  weal.  We  have  our 

(13) 


14 

own  courts,  our  own  system  of  supply  and  subsistence,  our  own 
rules  and  regulations,  and  of  this  community  of  some  68,000,  you 
and  I  and  our  colleagues  in  the  corps  are  the  sole  guardians  of  the 
public  and  individual  health.  You  are  one  among  347.  It  should 
be  your  aim  to  make  those  other  346,  and  the  rest  of  that  68,000, 
realize  that  you  mean  business.  You  already  have  a  name  in  the 
corps.  By  your  personality,  by  your  activities,  your  fellow  officers 
will  soon  be  classing  you  as  a  drifter  or  as  a  worker.  Service  repu- 
tations once  established  are,  justly  or  not,  often  the  permanent 
indices  of  a  man's  ability  or  desirability.  And  you  will  find  that  a 
good  name  is  easily  acquired,  a  poor  one  difficult  of  erasure.  Com- 
mand the  respect  of  your  fellow  officer?  and  of  your  future  patients. 
Establish  the  foundations  of  a  good  name  early,  and  the  later  main- 
tenance of  it  is  easy.  Competition  for  preeminence  offers  far  greater 
rewards  for  success  than  the  same  energy  expended  in  private  prac- 
tice, where  you  are  one  struggling  among  150,000  others.  Merit  is 
more  easily  recognized,  and  recognition  of  this  by  your  fellow  officers 
gives  in  the  end  reward  ample  in  itself,  in  the  lasting  consciousness 
of  their  admiration,  respect,  and  esteem.  Material  rewards  to  excel- 
lence and  mediocrity  may  seem  at  times  to  be  the  same,  but  this  is 
not  so,  as  shown  in  the  passage  of  years  hi  the  value  of  the  posi- 
tions assigned,  and  the  opportunities  afforded  the  worker  for  ex- 
ploitation of  his  talents.  Be  altruistic  with  your  time  and  labors. 
Subserve  self  to  loyalty  to  service  and  to  country.  The  common 
good  is  your  aim.  Your  increased  efforts  are  not  rewarded  finan- 
cially more  than  those  of  your  slothful  shipmate.  You  are  not 
battling  for  pelf — let  us  hope  the  ethics  and  higher  ideals  of  the 
medical  profession  make  this  a  rarity — your  living  is  not  haunted 
by  the  specter  of  the  wolf  that  may  be  behind  the  door  hi  days  of 
sickness  and  reverse.  Therefore,  all  the  more  is  your  time  available 
for  thoughts  and  actions  for  the  bettering  of  the  conditions  of  the 
personnel  under  your  charge,  or  for  scientific  research  or  study. 
And  in  the  formative  state  you  are  now  in,  your  earliest  steps  should 
take  you  into  the  path  that  tends  ever  upward  in  ideals  and  profi- 
ciency. Realize  constantly  that  it  is  to-day  that  counts.  Idleness 
and  lethargy,  industry  and  initiative,  the  spirit  of  "just  enough," 
the  spirit  of  "never  enough" — choose  between  them. 

The  process  of  selection  and  elimination  has  long  ago  started  with 
each  one  of  you,  and  you  represent  the  survival  of  the  fittest.  Of 
those  that  matriculated  with  you  at  your  university  or  medical 
school,  many  have  fallen  by  the  wayside.  Your  emergence  from 
that  ordeal  alone,  with  the  coveted  diploma,  is  in  itself  a  creditable 
achievement.  In  preparation  for  the  formation  of  this  class,  57  appli- 
cants received  permission  to  appear  for  examination.  You  eleven 
represent  a  20  per  cent  survival  of  that  57.  You  have  found  during 


15 

your  six  months  here  that  selection  is  still  potent,  and  the  price  of 
application,  of  early  training  or  aptitude,  of  hereditary  or  acquired 
ability,  is  paid  more  promptly  than  you  will  often  find,  in  the  deter- 
mination of  your  service  rank  by  your  school  standing. 

For  you,  gentlemen,  the  future  holds  all  variety  in  service  duties 
and  opportunities.  You  will  see  the  four  corners  of  the  earth;  you 
will  be  operating  surgeons,  executives,  and  commanding  officers  of 
magnificent  hospitals  and  hospital  ships ;  you  will  be  the  only  attend- 
ant by  some  poor  aborigine  in  childbed — I  do  not  dare  to  say  of  any 
question  that  may  by  the  wildest  flight  of  imagination  impinge  upon 
the  boundaries  of  your  profession,  that  you  may  not  be  called  upon 
some  day  momentously  to  decide  it.  You  must  be  adept  in  all 
things,  alert  in  all  ways  in  the  practice  of  your  profession,  in  adding 
to  your  knowledge  of  it,  and  in  keeping  pace  with  current  advance 
therein.  The  independence  of  isolated  stations  makes  it  necessary 
that  the  naval  medical  officer  be  a  specialist  in  all  things  relating  to 
medicine  in  the  widest  application  of  the  word. 

To  the  average  young  man  surgery  seems  to  offer  the  most 
attractive  field  in  planning  his  life  work.  It  is  in  many  ways  the 
most  spectacular  and  to  the  imagination  the  most  romantic.  You 
will  find  that  the  gratification  of  this  ambition  will  occur  in  your  naval 
duties  with  a  much  greater  certainty  than  in  private  practice,  where 
it  is  achieved  only  after  years  of  struggle  for  the  opportunity  to 
demonstrate  your  ability,  or  by  the  most  exceptional  occurrence  of 
an  early  assignment  as  member  of  some  hospital  visiting  staff.  Your 
entrance  examinations  into  this  service  and  our  knowledge  of  you 
since  have  demonstrated  to  us  that  you  are  each  of  you  qualified  to 
shoulder  such  responsibilities  to  the  credit  of  yourselves  and  the 
corps.  In  the  capacity  of  junior  you  will  find  that  your  seniors  will 
be  most  liberal  in  affording  you  material  and  opportunities.  The 
specialty  of  surgery  is,  however,  the  most  crowded  for  those  very 
reasons,  and  there  are  many  other  valuable  directions  that  may 
better  call  for  specialized  exercise  of  your  activities.  For  although 
I  am  insisting  always  that  you  can  not  remain  a  specialist  within  the 
usually  accepted  meaning  of  that  term,  that  is,  to  the  extent  of 
losing  intimate  touch  with  other  branches  of  your  profession  to  the 
benefit  of  your  particular  work,  this  by  no  means  precludes  the  fol- 
lowing of  a  particular  line  of  endeavor,  provided  your  state  of  general 
preparedness  does  not  suffer  thereby.  The  Navy  constantly  has  need 
of  specialized  activities,  and  the  man  with  special  knowledge,  the  man 
who  has  by  inheritance  or  by  application  something  that  his  neigh- 
bors have  not,  will  inevitably  be  turned  to  in  time  of  need.  Pre- 
paredness or  unpreparedness,  familiar  terms  to-day,  mean  as  much 
to  you  and  your  future  as  they  do  to  the  life  of  our  Nation.  For  the 
distinction  of  special  effort  or  special  place  your  preparedness  must 


16 

make  itself  known;  do  not  hide  your  light  under  a  bushel.  Let  us 
all  know  to  whom  we  can  turn  for  an  investigation  on  this  subject,  a 
report  on  that,  who  is  a  particularly  good  laboratory  man,  clinician, 
hygienist,  alienist,  aurist,  oculist,  roentgenologist,  etc. 

The  current  number  of  our  Naval  Medical  Bulletin,  April,  1916, 
affords  an  interesting  elucidation  of  this  theme.  Seven  of  the  nine 
special  articles,  all  emanating  from  the  pens  of  members  of  your 
own  corps,  relate  to  subjects  and  activities  concerning  which  your 
training  up  to  the  present  time  has  told  you  little  or  nothing. 
"The  occupational  distribution  of  physical  disability"  represents  the 
viewpoint  of  and  lessons  learned  by  the  industrial  student  and 
economist;  "The  exclusion  of  the  mentally  unfit  from  the  military 
services,"  points  out  your  duties  from  the  alienist's  standpoint  in 
conserving  the  health  and  morale  of  our  personnel;  "A  greater  field 
of  activity  for  medical  officers  of  navy  yards"  is  a  resumS  of  unusual 
ideals  and  activities  not  only  projected  but  achieved;  "The  hospital 
steward"  and  "The  new  hospital  corps  forms"  pertain  to  your  share 
in  supervision  of  the  Hospital  Corps;  "Studies  pertaining  to  light  on 
shipboard"  is  a  representation  of  the  most  advanced  work  and 
thought  on  illumination  under  working  conditions  aboard  our  modern 
battleships;  and  "Fumigation  of  the  U.  S.  S.  Tennessee  by  the  cyanid 
method"  tells  its  own  story. 

It  is  as  a  result  of  their  own  industry,  application,  research,  that  these 
officers  can  contribute  to  the  general  good  these  data  on  economics, 
recruiting,  navy-yard  duty,  executive  details,  lighting  problems,  etc., 
and  by  their  efforts  have  accentuated  their  own  value  to  the  corps 
and  the  corps  value  to  the  service  at  large. 

I  have  but  touched  on  the  possibilities.  Our  special  hospital  for 
the  tubercular;  the  tropical  medicine  opened  up  by  our  Philippine 
possessions;  the  many  naval  hygienic  problems  as  regards  food, 
light,  air,  clothing,  water  supply,  submarine  life,  diving,  quarantine, 
etc.;  specialized  work  at  the  Naval  Academy  hi  athletics;  our  pa- 
ternalism at  Guam  and  Samoa,  with  responsibilities  innumerable — 
these  all  represent  activities  and  possibilities  that  depend  but  upon 
your  own  initiative  to  achieve  distinction  and  place  in  universal 
admiration  and  regard. 

In  so  far  as  is  consonant  with  routine  service  needs  and  possibili- 
ties I  am  always  glad  and  willing  to  assist  in  the  gratification  of  such 
ideals.  You  will  always  find  that  the  bureau  has  only  the  public 
good  in  mind  and  that  the  only  favorite  that  is  played  is  ability. 
An  equalization  of  duties,  undue  favors  to  none,  broadening  oppor- 
tunities to  all,  these  are,  of  course,  what  we  constantly  strive  for  as 
helping  the  individual  in  preparation  for  the  many-sided  service  life 
and  as  supplying  to  the  needs  of  that  service  prepared  and  resource- 
ful officers. 


17 

And  now  what  is  your  personal  standard  of  life  and  morals  in  the 
new  relations  into  which  you  are  now  entering?  There  is  an  old 
conjunction  of  the  words  "an  officer  and  a  gentleman,"  which,  I 
hope,  will  always  be  to  you  more  than  a  mere  cant  phrase,  or  care- 
lessly accepted  fact.  To  be  a  gentleman,  kind,  manly,  courteous, 
upright,  is  what  we  all  owe  to  our  position  in  this  great  crowded  com- 
munity, the  world,  where  we  are  constantly  elbowing  our  way  up 
or  down  the  surging  path  of  life.  And  in  this  new  life  and  among 
these  new  surroundings  and  responsibilities,  where  your  life  and 
actions  are  more  arbitrarily  fixed  than  in  that  larger  community, 
still  more  so  will  you  find  it  necessary  to  observe  these  tenets.  Make 
your  lives  sober  and  dignified.  Make  it  a  subconscious  spur  with  you 
constantly  that  you  acquire  and  keep  the  respect  of  your  fellow  offi- 
cers and  of  the  enlisted  men.  It  is  well  to  be  liked  by  your  ship- 
mates, but  to  be  respected  personally  and  professionally  is  what  is 
more  difficult  of  achievement,  but  more  lasting  in  effects. 

The  "hail-fellow-well-met,"  the  ever-welcome  "rounder,"  the 
"good  fellow,"  is  generally  likeable  or  even  lovable,  and  his  name  or 
his  stories  or  his  exploits  may  be  hailed  with  glee  and  his  assignment 
to  a  mess  welcomed  with  joy,  but  in  time  of  illness  or  of  stress 
it  is  probable  that  this  type  will  not  be  as  freely  granted  the  confi- 
dence that  the  more  serious-minded  student  would  receive.  Your 
lives  will  have  little  hidden  from  the  close  association  of  wardroom 
contact,  and  at  one  time  or  another  you  will  be  called  upon  to  attend 
these  intimates  in  times  to  them  of  greatest  stress  or  danger,  either 
to  themselves,  or  their  wives,  their  mothers,  or  their  chidren,  and  in 
the  trust  and  faith  these  show  in  your  personal  and  professional 
integrity  will  be  your  greatest  reward. 

It  may  not  be  amiss  at  this  point,  the  closing  of  the  year's  work  in 
the  Medical  Department,  to  review  for  your  information  the  progress 
we  have  made  in  the  past  two  years  hi  our  work.  Last  year  and  the 
year  before,  in  retrospect,  I  paid  due  tribute  to  the  efforts  of  Surg. 
Gen.  Kixey  and  others  in  the  work  or  reorganization  and  rehabilita- 
tion of  the  Medical  Department  of  the  Navy,  stating  that  no  one 
man  ever  had  accomplished  more  or  probably  would  accomplish  more 
hi  this  respect  than  Admiral  Rixey.  During  the  past  two  years,  the 
present  Secretary  of  the  Navy,  in  many  instances  on  his  own  sugges- 
tion and  hi  others  by  his  support  of  the  Bureau  of  Medicine  and  Sur- 
gery, has  advanced  our  service  in  the  following  items: 

1.  He  has  recommended  to  Congress  the  increase  of  the  Medical 
Corps  from  347  to  nearly  500,  the  first  increase  in  20  years,  and  most 
urgently  needed. 

2.  He  has  provided  in  his  personnel  bill  a  substantial  increase  in 
the  upper  grades  of  the  Medical  Corps.     No  increase  in  these  grades 


18 

has  been  made  since  1870,  notwithstanding  the  tremendous  growth 
of  the  service  as  a  whole. 

3.  He  has  established  two  of  the  finest  Hospital  Corps  Training 
Schools  in  the  world  for  the  training  of  male  nurses,  and  made  pro- 
vision for  the  increase  in  this  corps  by  nearly  1,000  men,  an  increase 
urgently  demanded  by  the  increase  hi  the  Navy,  and  has  also  pro- 
vided a  possible  chance  for  members  of  this  corps  to  reach  commis- 
sioned rank,  thereby  raising  the  efficiency  and  esprit  of  nearly  2,000 
enlisted  men  in  the  Hospital  Corps  of  the  Navy. 

4.  He  has  made  provision  for  a  new  hospital  ship  for  the  Navy, 
which  will  enable  us  to  build  the  first  ship  of  this  kind,  designed 
especially  for  this  purpose,  and  which  will  be  a  model  for  our  country 
and  the  world.     This  one  effort  will,  if  granted  by  Congress,  be  of 
inestimable  value  to  the  Navy  and  to  all  other  countries.     It  will 
provide  our  fleet  and  our  service  with  a  floating  hospital  for  the  care 
of  the  sick  and  injured  of  the  Navy  that  will  rival  any  metropolitan 
hospital  in  existence. 

5.  He  has  established  schools  for  the  training  of  the  native  women 
of  Samoa  and  Guam  in  nursing,  that  already  are  giving  most  excellent 
results  and  are  a  most  important  humanitarian  educational  effort  for 
these  helpless  people,  promising,  when  completed,  to  be  one  of  the 
noblest  efforts  made  for  the  uplifting  of  any  similar  class  of  people. 

6.  He  has  increased  our  appropriations  to  meet  our  necessities  and 
to  enable  us  to  carry  on  our  great  work  that  extends  not  alone  to  the 
Navy  proper,  but  to  thousands  of  human  beings  attached  to  the  ser- 
vice in  various  ways  and  extending  to  all  parts  of  the  world. 

7.  He  has  permitted  us  to  take  an  active  part  in  the  regeneration 
of  Haiti  by  furnishing  medical  officers  and  nurses  to  care  for  the  sani- 
tary needs  of  the  great  work  that  is  now  in  progress  in  Haiti  and 
which  ranks  with  one  of  our  greatest  humanitarian  efforts. 

8.  He  has  supplied  already,  and  gradually  will  furnish  our  defici- 
encies in  the  many  large  hospital  and  medical  organizations  on  shore, 
such  as  contagious  units  at  Mare  Island,  Puget  Sound,  New  York, 
and  Newport,  and  has  furnished  adequate  and  commodious  homes 
for  our  nurses  at  Mare  Island  and  Boston,  thus  adding  to  the  content 
and  efficiency  of  the  women  nurses.     South  of  Norfolk  and  San  Fran- 
cisco our  coast  line  is  practically  unprovided  with   hospitals  for 
peace  and  war,  but  with  a  policy  defining  permanent  naval  stations 
his  attention  has  already  been  turned  to  the  needs  of  the  medical 
department.     That  we  may  not  be  unprovided  in  this  respect  hi  emer- 
gency; he  has  authorized  our  efforts  with  the  Red  Cross  and  we  are 
now  beginning  the  organization  of  five  Red  Cross  hospital  units 
(mobile  hospitals  of  250  beds  each,  with  personnel  and  equipment 
complete)  that  can  be  called  at  notice  to  any  point  of  this  coast  line 
where  needed. 


19 

9.  He  has  authorized  a  Medical  Reserve  Corps  of  the  best  medical 
talent  that  our  country  can  furnish,  to  be  ready  to  come  to  our 
assistance  in  tune  of  need,  and  to  prepare  this  group  of  the  Medical 
Corps  he  is  initiating  a  correspondence  school  that  shall  give  these 
officers  a  training  and  working  knowledge  of  their  work  when  called 
upon.     Realizing  the  great  lesson  to  be  learned  from  the  present 
European  war,  he  has  detailed  a  number  of  our  best  officers  for 
duty  in  Europe  as  observers,  and  the  excellent  results  already  show 
in  the  report  of  Surg.  Fauntleroy,  whose  work  has  added  greatly 
to  the  professional  knowledge  of  all  who  are  interested  in  medico- 
military  matters  and  is  a  credit  to  our  service. 

10.  The  above  are  only  a  few  examples  showing  the  interest  and 
activity  of  our  secretary  in  this  branch  of  the  service.     Did  tune  per- 
mit I  should  like  to  continue  in  detail  to  show  you  his  interest  and 
help  as  shown  in  innumerable  questions  of  sanitation  and  organiza- 
tion which  makes  the  work  of  the  Medical  Department  of  the  Navy 
one  of  the  most  important  branches  of  the  service.     Our  work  is 
most  highly  specialized,  dealing  as  it  does  with  so  many  questions, 
not  alone  with  the  healing  of  disease  but  with  all  that  pertains  to 
the  orderly  and  successful  running  of  this  great  department  of  the 
Government.     The  work  of  the  Bureau  of  Medicine  and  Surgery 
touches  ultimately  that  of  every  other  bureau  in  the  department 
and  makes  us  one  of  the  busiest  and  most  active  corps. 

I  have  frequently  asked  myself  how  is  it  that  the  head  of  the  Navy 
is  so  sanely  interested  in  our  work,  and  seems  to  comprehend  our 
needs  often  before  they  are  presented  to  him,  and  I  think  the  solution 
lies  in  the  fact  of  his  education  along  medical  lines.  This  comes,  I 
feel  sure,  from  the  association  with  medical  men  of  great  worth  and 
ability.  Where  has  he  had  this  association  that  has  taught  him  the 
importance  of  medical  work  in  the  welfare  of  the  nation '?  From  all 
I  can  learn,  it  has  come  from  the  intimate  friendship  and  association 
of  his  family  medical  advisers,  one  of  whom  has  honored  us  by  his 
presence  here  to-day,  and  to  them  I  feel  we  owe  and  the  nation  owes 
a  deep  debt  of  gratitude  for  the  impress  they  have  made  on  this  one 
man.  How  nobly  and  how  splendidly  have  these  medical  men  of 
Raleigh  stood  sponsor  for  their  profession.  They  have  built  better 
than  they  knew  and  in  this  light  I  want  to  thank  Dr.  Royster  and 
his  associates  in  Raleigh  for  the  great  benefits  that  have  come  in  this 
way  to  the  Navy  through  them.  Theirs  is  the  credit,  and  I  trust  our 
grateful  appreciation  is  their  reward. 

In  conclusion,  gentlemen  of  the  graduating  class,  I  wish  you  every 
success  in  your  new  life  and  trust,  as  the  years  go  by,  we  shall  have 
only  congratulations  to  give  you  for  work  well  done. 


ADDBESS  OF  HTTBEBT  A.  BOYSTEB,  M.  D., 

Raleigh,  N.  C. 

"THE  HUMANITY  OF  STJBGEBY." 

At  the  first  blush  it  would  seem  to  be  asking  too  much  of  a  civil 
surgeon  to  instruct,  advise,  or  entertain  the  naval  surgeon.  Their 
purposes,  environment,  and  training  lie  in  very  different  directions. 
Yet  they  have,  of  course,  a  common  interest.  That  interest  is  the 
service  of  humanity.  Upon  that  basis  we  can  unite  hi  an  attempt  to 
redress  certain  popular  misconceptions  of  surgery,  in  a  consideration 
of  some  of  those  vital  things  which  control  us  all  hi  the  practice  of 
our  art,  and  in  an  application  of  these,  if  possible,  to  the  particular 
affairs  which  constitute  your  own  sphere  of  work. 

In  the  early  days  surgeons  were  looked  upon  as  mere  mechanics. 
In  fact  the  derivation  of  the  term  surgery,  or  chirurgery,  from  two 
Greek  words,  meaning  "handwork,"  signifies  its  original  application. 
The  surgeon  was  the  barber  and  was  regarded  as  of  a  lower  order  than 
the  physician,  under  whose  guidance  he  acted.  We  have  not  yet 
entirely  outlived  this  impression,  for  even  at  the  present  day  it  is  held 
by  some  that  it  requires  a  higher  degree  of  intellectual  capacity  and 
a  sounder  judgment  to  be  an  eminent  medical  consultant  than  it  does 
to  be  a  great  surgeon.  Moreover,  the  surgeon  has  been  called  a 
"butcher";  it  is  said  that  he  "loves  to  cut";  he  is  commonly  spoken 
of  as  one  who  "thinks  no  more  of  operating  on  human  flesh  than  of 
sawing  on  so  much  wood."  Perhaps  these  criticisms  are  natural. 
But  let  us  ask  ourselves  if  they  are  just.  Have  we  endeavored  to 
counteract  such  impressions,  or  have  we  deserved  the  criticism  ? 

Who  does  not  now  know  that  the  surgeon,  besides  bearing  all  the 
burdens  connected  with  operative  technic,  shares  equally  with  the 
physician  the  responsibilities  of  diagnosis  and  af  tertreatment  ?  The 
modern  surgeon  who  is  not  skilled  in  clinical  diagnosis  fails  to  measure 
up  to  the  standard  set  by  his  advancing  science.  Further,  the 
surgeon  who  is  lacking  in  general  knowledge  of  disease  and  in  the 
use  of  remedies  will  never  ripen  into  true  greatness.  This  has  been 
well  expressed  by  Ashhurst  in  these  words:  "The  importance  and 
even  necessity  of  a  thorough  knowledge  of  practical  anatomy  can, 
indeed,  scarcely  be  overrated;  yet  it  is  more  essential  for  the  surgeon 
to  be  well  versed  in  pathology  and  therapeutics  (or  hi  other  words, 
to  be  an  accomplished  physician)  than  it  is  for  him  to  know  the 
attachments  of  every  muscle  in  the  body,  or  all  the  possible  variations 
of  arterial  distribution." 

(20) 


21 

Let  no  one  suppose  this  is  a  plea  for  loose  methods  at  the  expense 
of  scientific  surgery.  It  simply  means  the  blending  of  mind  and 
hand,  the  joint  partnership  of  judgment  and  action,  with  proper  faith 
in  each.  We  can  not  leave  out  the  human  equation  if  we  are  to  round 
out  a  life  of  usefulness.  We  must  be  men  before  we  are  surgeons. 
Character  must  be  the  foundation  for  skill;  for  what  you  are  will 
show  in  what  you  do.  Is  it  true  that  in  our  rush  of  work  we  are 
losing  somewhat  the  human  touch,  the  personal  interest?  No 
matter  how  we  shall  answer  this  question,  we  can  truthfully  confess, 
believe  me,  that  the  eminent  surgeons  of  the  generation  just  pre- 
ceding us  were  men  of  great  individual  power,  and  that  they  deserved 
more  credit  for  the  results  they  achieved  than  we  do  for  the  success 
we  have  attained.  They  helped  us  to  grow  out  of  the  mechanic 
into  the  modern  operator,  to  advance  from  the  bonesetter  to  the 
diagnostician.  And  they  have  left  us  much  to  emulate. 

"  We  think  our  fathers  fools,  so  wise  we  grow; 
Our  wiser  sons,  perhaps,  will  think  us  so." 

One  of  the  common  misconceptions  in  regard  to  surgery  is  that 
the  knife  is  considered  its  symbol.  That  most  dreaded  of  all  instru- 
ments is  chosen  to  typify  the  whole  surgical  art,  and  such  expressions 
as  "going  under  the  knife,"  "nothing  but  the  knife  will  do,"  or  the 
"horror  of  the  knife,"  are  frequently  heard  both  from  the  laity  and 
from  medical  men.  The  truth  is  that  the  knife,  while  of  course  one 
of  the  most  important  instruments,  is  really  used  less  than  are  many 
other  instruments.  A  being  of  stern  visage  brandishing  the  scalpel 
would  not  be  a  true  picture  of  the  surgeon;  rather  should  he  be 
represented  as  one  of  calm  countenance  with  a  handful  of  hemostats 
or  a  needle  and  thread — instruments  far  less  gruesome,  but  more 
widely  employed  and  requiring  greater  ingenuity  in  then-  use.  Besides, 
there  are  many  operations  done  wholly  without  the  knife.  The 
singling  out  of  this  alarming  implement  as  the  popular  embodiment 
of  surgery  is  but  a  sign  of  the  fascination  for  most  minds  of  the 
terrifying  and  the  dramatic.  It  smacks  of  the  old  days  of  the  barber 
surgeon. 

The  most  satisfying  thought  to  one  in  the  practice  of  surgery  is 
the  consciousness  of  having  directly  rescued  or  prolonged  the  lives 
of  one's  fellow  creatures.  In  no  branch  of  the  profession  is  the 
relation  of  cause  and  effect  so  manifest  or  the  personal  responsi- 
bility so  obvious  as  in  surgery.  A  patient  under  medical  treatment 
may  be  managed  with  consummate  skill,  may  be  carried  over  diffi- 
culties and  snatched  from  dangers,  and  yet  so  many  factors  enter 
in  as  to  preclude  us  from  saying  that  any  one  dose  turned  the  tide 
or  any  one  act  alone  produced  the  result.  Not  so  with  the  surgical 
case.  In  every  operation  a  life  is  immediately  at  stake  and  the 
operator  himself  is  the  accountable  agent.  The  very  risk  is  alluring 


22 

and,  therefore,  the  gratification  the  greater.  To  remove  a  tumor, 
which  is  slowly  but  surely  killing  the  sufferer;  to  evacuate  a  pus 
collection,  breeding  poison  and  death;  to  correct  a  deformity  and 
see  the  joy  over  the  outcome;  to  ligate  a  bleeding  vessel  and  thus 
actually  keep  life's  blood  in  the  body — no  human  feeling  compares 
with  these  sources  of  profound  mental  satisfaction,  which  are  the 
surgeon's  daily  heritage. 

Those  who  practice  surgery  are  either  ennobled  or  degraded  by  it. 
Their  characters  are  developed  and  sweetened  or  else  made  coarse. 
There  is  no  halfway  ground.  Looked  upon  as  so  much  slashing, 
surgical  operations  do  but  brutalize  those  that  perform  them;  viewed 
hi  the  light  of  God-given  occasions  for  exercising  skill  and  healing 
humanity,  they  are  the  means  of  uplifting  and  purifying.  The 
heroism  often  exhibited  by  patients  can  not  but  have  its  effect  upon 
the  surgeon's  character.  Who  can  behold  uninfluenced  a  calm 
mental  and  moral  attitude  toward  physical  suffering?  Who  of  us 
has  not  seen  the  sufferer  himself  do  his  part  as  well  as  we  did  ours  and 
at  times  surpass  us  in  courage?  To  have  ministered  to  even  one  of 
these  is  worth  a  lifetime  of  worry. 

In  the  case  of  a  well-poised  surgeon  this  reflection  upon  the  hu- 
manity of  his  patient  will  detract  in  no  wise  from  his  own  boldness 
or  self  control.  It  should  rather  give  him  more  sensible  conscious- 
ness of  the  right  and  a  larger  conception  of  his  duty  to  do  it.  After 
all,  "nerve"  may  be  defined  as  knowing  what  you  are  doing.  An 
operator  who  possesses  that  confidence  born  of  upright  judgment 
and  intimate  knowledge  feels  at  home  under  all  conditions  in  which 
he  places  himself.  Mere  assumption  of  bravery  is  a  counterfeit; 
recklessness  is  not  "nerve."  The  renowned  Valentine  Mott  in  his 
later  days  stepped  into  the  amphitheater  where  one  of  his  younger 
colleagues  was  doing  a  herniotomy  and  saw  the  operator  at  one  stroke 
cut  through  the  tissues  down  upon  the  sac.  With  a  shudder  the  old 
surgeon  exclaimed,  "Lord,  save  the  man!"  and  walked  away  from 
the  table.  Glancing  back  again  after  a  few  minutes,  he  remarked, 
"He  did." 

Surgeons  everywhere  have  been  called  upon  to  perform  services  of 
the  most  heroic  kind;  and,  be  it  said  to  their  credit,  they  have  been 
found  for  the  most  part  sufficient  for  their  tasks.  Even  in  civil  life 
examples  are  not  lacking.  My  own  state  presents  an  instance  of  the 
highest  type  in  the  person  of  Edmund  Stmdwick,  who  by  one  deed 
would  have  the  title  of  hero.  Not  in  all  the  annals  of  history  have 
I  read  of  nor  is  it  in  my  mind  to  conceive  of  firmer  devotion  to  duty 
or  of  more  daring  fortitude  than  he  exhibited.  When  near  sixty 
years  of  age  he  was  called  to  a  distant  county  to  perform  an  opera- 
tion. Leaving  on  a  9  o'clock  evening  train,  he  arrived  at  his  station 
about  midnight  and  was  met  by  the  physician  who  summoned  him. 


23 

Together  they  got  into  a  carriage  and  set  out  for  the  patient's  home 
six  miles  in  the  country.  The  night  was  dark  and  cold;  the  road, 
was  rough;  the  horse  became  frightened  at  some  object,  ran  wild, 
upset  the  carriage  and  threw  the  occupants  out,  stunning  the  country 
doctor  (who  it  was  afterward  learned  was  addicted  to  the  opium 
habit)  and  breaking  Dr.  Strudwick's  leg  just  above  the  ankle.  As 
soon  as  he  had  sufficiently  recovered,  Dr.  Strudwick  called  aloud, 
but  no  one  answered;  and  he  then  crawled  to  the  side  of  the  road 
and  sat  with  his  back  against  a  tree.  In  the  meantime  the  other 
physician,  who  had  somehow  managed  to  get  into  the  carriage  again, 
drove  to  the  patient's  house,  where  for  a  time  he  could  give  no 
account  of  himself  or  of  his  companion;  but,  coming  out  of  his 
stupor,  he  faintly  remembered  the  occurrence  and  at  once  dis- 
patched a  messenger  to  the  scene  of  the  accident.  Dr.  Strudwick 
was  still  leaning  against  the  tree,  calling  now  and  then  in  the  hope  of 
making  some  one  hear,  when  the  carriage  came  up  about  sunrise. 
He  got  in,  drove  to  the  house,  without  allowing  his  own  leg  to  be 
dressed,  and,  sitting  on  the  bed,  operated  upon  the  patient  for 
strangulated  hernia  with  a  successful  result.  "Greater  love  hath  no 
man  than  this." 

The  records  of  military  surgery  are  so  full  of  valorous  deeds  and 
gallant  sacrifices  that  it  would  be  superfluous  to  point  them  out. 
They  are  the  rule  rather  than  the  exception.  Your  training  here,  I 
am  sure,  has  brought  you  to  value  the  opportunities  which  may 
come  to  you  for  proving  your  courage  as  well  as  your  skill  and  your 
humanity.  Honored  names  are  those  which  stand  out  on  the  list  of 
American  naval  surgeons,  honored  for  their  worth,  their  work,  and 
their  wisdom.  Examples  are  not  wanting  over  the  whole  world  to 
demonstrate  the  important  parts  played  by  surgeons  of  various 
navies  in  the  history  of  their  profession  and  of  their  country. 

I  can  not  refrain  from  mentioning  Richard  Wiseman,  who  exercised 
so  wide  an  influence  over  British  military  surgery  in  the  seven- 
teenth century.  We  are  told  1  that,  having  finished  his  apprentice- 
ship at  the  Barber  Surgeons'  Hall,  he  entered  the  Dutch  naval 
service,  in  which  he  soon  saw  active  duty,  for  Holland  was  then  at 
war  with  Spain.  His  extensive  experience  prompted  him  to  teach 
that  bullets  should  be  extracted  at  once  and  that  primary  amputa- 
tion was  the  best  course  to  pursue  in  many  cases,  but  by  no  means 
in  all.  This  is  the  good  doctrine  that  he  preached:  "Consider  well 
the  member  and,  if  you  have  no  probable  hope  of  sanation,  cut  it 
off  quickly  while  the  soldier  is  heated  and  in  mettle.  But  if  there 
be  hopes  of  cure,  proceed  rationally  to  a  right  and  methodical  healing 
of  such  wounds;  it  being  more  to  your  credit  to  save  one  member 
than  to  cut  off  many."  And  again,  "Amongst  the  cruisers  in  private 

1  British  Journal  of  Surgery,  January,  1916. 


24 

frigates  from  Dunkirk  it  was  complained  that  their  chirurgeons  were 
too  active  in  amputating  those  fractured  members.  As  in  truth 
there  are  such  silly  brothers,  who  will  brag  of  the  many  they  have 
dismembered,  and  think  that  way  to  lie  themselves  into  credit. 
But  they  that  truly  understand  amputation  and  their  trade  well 
know  how  villainous  a  thing  it  is  to  glory  in  such  work."  What  an 
admirable  tribute  to  the  humanity  of  surgery!  How  nearly  he 
expresses  what  we  feel  to-day;  that  it  is  more  blessed  to  save  than 
to  destroy!  From  his  own  words  we  know  that  Wiseman  did  not 
lay  claim  to  great  physical  bravery,  for  he  confesses  that  on  one 
occasion  a  "sudden  cry  that  our  ship  was  on  fire  put  me  in  such  dis- 
order that  I  rather  thought  of  saving  myself  than  dressing  my 
patients."  And  later,  while  serving  with  the  English  army,  he  spoke 
of  making  excuses  to  a  wounded  man  so  successfully  that  he  "was 
at  liberty  to  fly  from  the  enemy  who  was  entered  into  the  town." 
We  may  not  judge  him  too  harshly  until  we  disprove  the  relation  of 
discretion  and  valor  or  the  connection  between  running  away  and 
another  day.  On  the  deck  and  in  the  field,  as  in  the  operating  room, 
it  sometimes  required  more  courage  to  get  out  than  it  does  to  stay  in. 

No  more  appealing  reflection  can  come  to  you  than  that  of  the 
university  of  science.  She  speaks  in  every  language,  she  dwells  in 
every  land,  she  waits  on  every  age.  It  has  been  written:  "All  that 
is  best  in  the  great  poets  of  all  countries  is  not  what  is  national 
in  them  but  what  is  universal."  May  we  not  make  equal  claim  for 
our  own  science  and  say  the  same  for  the  great  surgeons  of  the 
world  ?  In  the  work  which  you  have  chosen  you  can  not,  you  will 
not,  know  friend  or  foe;  with  disease,  destruction,  and  death  all 
around  you,  your  concern  will  be  for  help  and  hope  to  all  those  under 
your  care.  Patriots?  Yes;  but,  above  all,  seekers  for  truth  and 
servants  of  humanity. 

Even  from  its  most  unsatisfactory  side,  surgery  must  be  looked 
upon  as  a  humane  art,  for  its  aid  is  usually  invoked  as  a  last 
resort.  When  all  other  means  have  failed,  it  has  been  customary  to 
advise  surgical  interference,  and  relief  must  come,  if  it  does  come, 
under  most  adverse  and  unpromising  conditions.  How  much  better 
if  surgery  were  made  an  early  resort,  if  not  a  first  resort,  in  cases 
where  it  is  surely  demanded.  Too  late!  the  saddest  expression  in 
our  language.  In  surgery  these  words  mean  hopelessness  and  de- 
spair. Operations  done  too  soon  are  curiosities ;  so  rare  in  fact  as  to 
be  inconsiderable.  Operations  done  too  late  are  the  popular  reproach 
of  our  art.  All  the  merciful  instincts  of  our  nature  demand  that  a 
disease  inevitably  dependent  upon  surgical  treatment  be  submitted 
to  such  procedure  at  a  time  when  the  outlook  will  admit  of  a  success- 
ful issue  and  not  temporized  with  until  the  last  chance  is  passing 
away.  The  disease  must  not  be  allowed  to  kill  the  patient  before 


25 

the  operation  can  save  him.  Keep  it  ever  in  mind  that  surgical 
mortality  is  due  chiefly  to  havoc  wrought  by  the  pathological  changes 
already  present  and  only  in  comparatively  rare  instances  to  the  opera- 
tion itself.  It  is  humane  surgery,  therefore,  to  act  when  a  life  can 
be  preserved  and  not  to  delay  until  it  is  placed  in  jeopardy.  There 
is  such  a  thing  as  preventive  surgery — the  high-water  mark  of  all 
our  future  efforts. 

Let  us  feel,  then,  that  in  the  practice  of  surgery  there  are  situa- 
tions calling  for  the  exercise  of  a  larger  and  deeper  portion  of  humanity 
than  the  surface  markings  seem  to  indicate.  The  keynote  of  sur- 
gery is  hopefulness,  or,  as  expressed  by  another,  "  magnificent 
optimism,"  and  its  devotees  constantly  exhale  this  spirit.  It  is 
unjust  to  think  of  the  surgeon  as  one  who  " loves  to  cut"  at  all 
hazards  and  who  cares  not  for  consequences.  The  very  essence  of 
our  calling  impels  us  to  strive  for  permanence  and  perfection. 
Humanity  teaches  us  that  it  is  an  exalted  privilege  to  relieve  suf- 
fering; it  also  bids  us  know  that  it  is  much  nobler  and  more  com- 
passionate to  cure  the  complaint.  Surgery's  mission  is  to  heal,  to 
restore,  to  remove  forever  the  offending  lesion.  It  is  with  this  spirit 
that  I  beg  you  to  become  imbued  as  you  depart  on  your  missions  of 
service.  Whether  you  go  to  the  east  or  to  the  west,  whether  you  be 
on  land  or  on  sea,  whether  your  lot  be  cast  in  war  or  in  peace,  I 
welcome  you  into  the  splendid  company  of  those  whose  days  are 
spent  in — 

"Battling  with  custom,  prejudice,  disease, 
"As  once  the  son  of  Zeus  with  Death  and  Hell." 


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LD  21-100m-7,'40  (6936s) 


YC» 05624 


Gayiord  Bros. 

Makers 
Syracuse.  N.  Y. 

p»T  Jtt.2I.W» 


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